TY - JOUR
T1 - Progression of conservatively treated endometrial complex atypical hyperplasia in a young woman
T2 - a case report
AU - Corrado, Giacomo
AU - Baiocco, Ermelinda
AU - Carosi, Mariantonia
AU - Vizza, Enrico
PY - 2008/11
Y1 - 2008/11
N2 - Objective: To describe a case of progression of endometrial complex atypical hyperplasia (CAH) to extrauterine endometrioid adenocarcinoma in a patient who had requested fertility-sparing management. Design: Case report. Setting: Division of Gynecologic Oncology, National Cancer Institute "Regina Elena," Rome, Italy. Patient(s): A nulliparous 36-year-old woman with endometrial CAH who decided on a conservative approach. Intervention(s): Conservative hysteroscopic resection of the lesion, the surrounding endometrium, and underlying myometrium plus hormone therapy regimen of megestrol acetate (160 mg) daily for 6 months. Main Outcome Measure(s): Failure of the conservative therapy and progression of disease. Result(s): Eighteen months after fertility-sparing management, a laparoscopic operation revealed grade 2 endometrium adenocarcinoma with superficial myometrial invasion and a microscopic metastasis of the left ovary and Douglas peritoneum. The patient underwent adjuvant chemotherapy followed by external beam radiation of the pelvis and brachytherapy. Twenty-five months after, she was free of disease. Conclusion(s): Conservative therapy is feasible in carefully selected young women with endometrial CAH. However, close follow-up is required because of possible progression to endometrial cancer.
AB - Objective: To describe a case of progression of endometrial complex atypical hyperplasia (CAH) to extrauterine endometrioid adenocarcinoma in a patient who had requested fertility-sparing management. Design: Case report. Setting: Division of Gynecologic Oncology, National Cancer Institute "Regina Elena," Rome, Italy. Patient(s): A nulliparous 36-year-old woman with endometrial CAH who decided on a conservative approach. Intervention(s): Conservative hysteroscopic resection of the lesion, the surrounding endometrium, and underlying myometrium plus hormone therapy regimen of megestrol acetate (160 mg) daily for 6 months. Main Outcome Measure(s): Failure of the conservative therapy and progression of disease. Result(s): Eighteen months after fertility-sparing management, a laparoscopic operation revealed grade 2 endometrium adenocarcinoma with superficial myometrial invasion and a microscopic metastasis of the left ovary and Douglas peritoneum. The patient underwent adjuvant chemotherapy followed by external beam radiation of the pelvis and brachytherapy. Twenty-five months after, she was free of disease. Conclusion(s): Conservative therapy is feasible in carefully selected young women with endometrial CAH. However, close follow-up is required because of possible progression to endometrial cancer.
KW - conservative therapy
KW - Endometrial complex atypical hyperplasia
KW - fertility
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U2 - 10.1016/j.fertnstert.2008.06.014
DO - 10.1016/j.fertnstert.2008.06.014
M3 - Article
C2 - 18692828
AN - SCOPUS:55149096803
VL - 90
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 5
ER -